JPH0463690B2 - - Google Patents

Abstract

A portable apparatus for monitoring heart activity, including two electrodes connected to a case which encloses an electronic signal processor. The electrodes are separate and applied to different parts of the cardiac region of the patient's bust, one electrode being exposed on a face of the case to contact a first zone on the patient's bust, the other electrode being independent of the case and contacting a second zone of the bust, the electrodes being connected electrically by a conductor which also serves as a strap to suspend the apparatus on the patient's body.

Description

DETAILED DESCRIPTION OF THE INVENTION Field of the Invention The present invention relates to a portable vibratory activity monitoring device for monitoring cardiac activity in various situations without the presence of a medical professional.

BACKGROUND OF THE INVENTION A device is provided with two electrodes for extracting an electrocardiogram, and consists of a housing housing an electronic processing unit for recording the electrocardiogram for transmission to a physician treating the patient, or for recording the pulse rate of the wearer. Proposed.

This type of device consists of a housing shaped like a cigarette pack and provided with two electrodes to which the patient's hand is applied to record an electrocardiogram at the moment of a complaint. This is very important in patients whose symptoms occur at a low recurrence rate. The electrocardiogram thus recorded is digitized and stored in memory for later reading by a medical professional.

Problems to be Solved by the Invention Although such devices are portable, they usually have to be taken out of a pocket, search for the electrodes and touch them with the hand, and are not immediately available. Although these operations are simple, they take time to consider under difficult circumstances when a disorder occurs, and an electrocardiogram recorded late in the development of the disease may not show any characteristics. Also, such devices are not always available when the patient is left in removed clothing or when the patient is wearing clothing that does not have pockets, such as especially summer clothes or sports clothes.

Also, since the recordings are made between the patient's hands, parasitic or artifactual effects may occur and cannot be removed, thereby reducing the quality of the electrocardiogram recording.

Additionally, watch-type devices and waist belt-type devices that have been developed in recent years can be worn permanently depending on the placement and fixing method of the electrodes, but the electrodes are not in the optimal location to obtain electrocardiographic signals, and The problem was that it was cumbersome for patients to wear it, and it gave them a feeling of depression.

The aim of the invention is to eliminate the above-mentioned drawbacks.

Means for Solving the Problems According to the present invention, there is provided a flexible loop made of a conductor that is hung around the patient's neck, and a flexible loop that is attached to the loop and suspended from the patient's chest in the form of a pendant. a first electrode portion whose contact position to the skin can be moved; a second electrode attached to a portion of the loop that is hung around the patient's neck; and a second electrode portion provided within the housing. and an electronic processing means for recording electrocardiogram signals detected by a second electrode section, the second electrode being in constant contact with the skin of the patient's neck due to the weight of the suspended first electrode section. A monitoring portable device is provided.

At least one electrode is in sustained contact with the patient's neck and the other electrode (if not in continuous contact)
Another part of the patient's upper body is quickly contacted to pick up signals from the expansion and contraction sensations of the patient's heart. This operation is particularly quick since the patient only needs to press the housing against the chest to start recording.

Also, because the electrodes are brought into contact with the heart region of the patient's upper body, the resulting signal is relatively free from parasitic effects and is of better quality than fixed electrocardiogram recording devices such as those commonly used in hospitals and clinics.

In one embodiment of the invention, a flexible loop is passed around the patient's neck like a necktie. The first electrode loop hangs from the patient's chest like a pendant, and the second electrode is located on the substantially opposite side of the loop and rests on the nape of the patient's neck.

The second electrode is in permanent contact with the scruff of the patient's neck, and the first electrode is quickly pressed against the patient's chest so that recordings can be made in the event of a complaint. Since it is a natural gesture to raise the hand to the chest in times of distress due to heart failure, it is almost instinctive that the gesture triggers an electrocardiogram recording. Second
The electrodes are maintained in permanent contact with the patient's skin by the weight of the loop and the housing suspended from the loop.

Due to the use of flexible loops, the device adapts to different body types of different patients. Patients can instantly press the housing against the appropriate part of their chest, regardless of their individual body shape.

In the present invention, the first and second electrodes are preferably flexible and comprised of twisted conductors.

In another embodiment of the present invention, the first electrode part is electrically connected to the first electrode part and attached to the housing of the first electrode part;
Preferably, an auxiliary electrode is also provided which is fixed to the patient's skin.

In a preferred embodiment said electronic processing means comprises analog-to-digital converter means responsive to signals from said electrodes, digital storage means for storing signals from said analog-to-digital converter means, and digital storage means for storing signals from said analog-to-digital converter means. and manual trigger means for triggering the storage of. Said storage means comprises a stacked memory format persistently responsive to said signals, and said triggering means is adapted to record an electrocardiogram corresponding to a period of time prior to manual actuation of said triggering means with permanent storage of said signals in said stacked memory format. It is effective in making you This configuration places the device in persistent monitoring or "sentinel" mode (sentinel mode is a form of stack memory;
It is a mode in which the electrocardiogram signal is continuously recorded, the old signal is erased when nothing happens, and when the button is pressed, the temple signal for a predetermined period before and after activation can be accumulated) The electrocardiogram is recorded as desired and includes a record of the conditions that preceded the time the recording was triggered.

In another preferred embodiment of the invention, the first electrode portion includes a housing attached to a conductive loop worn around the neck, a first electrode provided on the housing, and an electrical connection to the first electrode. It consists of a sub-housing connected to and attached to the casing, and a sub-electrode attached to the sub-housing and fixed to the patient's skin. connected to the electrode. Different types of recordings are made with this device from different other electrodes, and the recordings obtained are substantially identical to those obtained from a fixed electrocardiogram recording device.

EXAMPLE The device shown is attached by a conductive loop that is attached on one side to a housing housing an electronic signal processing device and on the other side serves to suspend and/or maintain the housing on the patient's body. Contains two separate electrodes. The conductive loop may be in the form of a harness or other form such as a shoulder strap worn on the patient's upper body.

In the embodiment shown in Figures 1 and 2, the electrical link or conductor 1 is a flexible conductor in the form of a loop which passes around the patient's neck and holds a second electrode 2 which is applied to the nape of the patient's neck. Consists of straps. The strap 1 holds a housing 3A of a first electrode section 3 that houses an electronic signal processing device and has a first electrode placed on its back surface. The strap 1 may be helically shaped as shown in FIG. 2 to have sufficient elasticity to allow the housing 3A to move into contact with different parts of the patient's chest.

The second electrode 2 consists of a small and thin casing on one side of which is placed a flat electrode that contacts the patient's skin. One surface 4 of the housing 3A of the first electrode section 3 also carries a first electrode 5 that contacts the patient's chest. These two electrodes 2, 5 are made of chain mail or braided stranded conductive material such that the electrodes are flexible and deform to fit the shape of the upper body part of the patient to which they are applied. is preferable.
Therefore, with this embodiment of the electrode, good contact is possible even when the area to which the electrode is applied has a lot of body hair.

In this embodiment of the invention, the first electrode part 3 has mechanically coupled electrical connection means for connection to a sub-electrode 7 which is permanently attached to the patient's chest. Sub-electrode 7
is a complementary bond (a mechanical bond is a bond made of two materials)
An electrical connection electrically connects two parts of electrically conductive material, whereas a mechanically coupled electrical connection consists of two parts of electrically conductive material.

In the illustrated embodiment, the mechanical coupling consists of a press stud type clip device, the first electrode part 3 having a female part 6 for coupling, and the auxiliary electrode 7 having a male part 8.
has. This connection is particularly shown in FIGS. 3 and 4, in which the female part 6 of the prestad is connected to the housing 3A.
There is no protrusion on the surface 4, and the auxiliary electrode 7 has a male portion 8 protruding thereon which fits into the female portion 6. The sub-electrode 7 has adhesive on both sides so that it adheres well to the housing 3A and the skin. The second electrode 2 may also be provided with a similar press stud type mechanical connection to connect it to the sub-electrode 7. Sub-electrode 7
is an ambulatory electrode known as a Holter electrode.

When the male part 8 of the sub-electrode 7 is fitted into the female part 6 of the housing 3A and the sub-electrode 7 is attached to the housing 3A by mechanical coupling, the electrode surface of the sub-electrode 7 is connected to the first electrode 5.
and an electrical connection is made.

Note that it is of course possible to use the first electrode part 3 in the state shown in FIG. 3 without using the sub-electrode 7 so that the first electrode 5 is applied to the patient's skin.

FIG. 5 shows yet another embodiment, in which a sub-device 9 is used as another sub-electrode consisting of a thin flat housing having a male part 11 on one side and a female part 12 on the other side. As shown in FIG. 5, the sub device 9 has a male part 11.
is fitted into the female part 6 of the casing 3A, and the female part 12 is fitted with the male part 8 of the sub-electrode 7, thereby being attached between the casing 3A and the sub-electrode 7. As shown in FIG. 8, the sub-device 9 is connected via cords to other electrodes 13, 14 and 15 which are attached to different predetermined locations on the patient's chest.

The illustrated device may be used in a variety of ways. In the first mode of operation, it is worn permanently by the patient, and the electrode 2 is in continuous contact with the nape of the patient's neck. When an illness occurs, the patient presses the housing 3A against his or her chest to begin recording for later diagnosis by a medical professional. The electronic signal processor includes a memory that stores several records of a predetermined length. The length and number of records will be determined by the physician. The records obtained and stored are read directly from the housing 3A by the doctor during the patient's examination.
Transmission means may be provided, for example by telephone, so that the records stored without an examination can be sent to the doctor. Press button 16 to start electrocardiogram recording.
This is preferably carried out by a control means provided on the outer surface of the housing 3A. This push button 16 is preferably provided so as not to protrude from the outer surface of the housing 3A to prevent inappropriate start of recording.

In another mode of operation of the device shown, the housing 3A has electrodes 7, 13, 14 and 1 with or without subdevices 9.
It is connected to one or more sub-electrodes such as No.5. The device operates in a surveillance or "sentinel" mode.
That is, the device records the electrocardiogram continuously in the stack memory of the electronic processor, and when the pushbutton 16 is pressed, the electrocardiogram corresponding to a period before and after the trigger is recorded in the fixed memory. This allows a doctor to make a more accurate diagnosis because an electrocardiogram that corresponds to the time when the patient's illness occurred and a short period before that time can be obtained. This mode of operation corresponds to the holder method, but does not have the disadvantages of the holder method since the device is very easy to wear. The device can therefore be worn for several days without difficulty.

In a third mode of operation of the illustrated device, the recorded signals are processed to obtain the user's pulse rate. Advantageously, upper and lower thresholds are defined and the processor issues an audible or visual alarm when the pulse rate exceeds the thresholds. This feature is particularly advantageous for patients undergoing retraining who must be careful not to exceed a certain pulse rate. It is also advantageous for other users such as athletes who wish to check their pulse rate during training without stopping their movements. It is also advantageous for deep-sea divers who need to check their sinks. In this case, the alarm is preferably luminescent.

FIG. 6 is a schematic block diagram of one embodiment of the electronic processor housed in the housing 3A. Electrodes 2 and 5
The generated signal is sent to a high input impedance differential amplifier 17, and the output signal of the differential amplifier 17 is converted into a digital signal by an analog-to-digital converter 18. Converter 18, in this embodiment, is an 8-bit converter operating at a rate of 100 samples per second.

The resulting 8-bit signal is conveyed via bus 19 to a control processing logic unit 21, a digital-to-analog converter 22 and a memory 33, which may be 2K octave of active memory (RAM). For example, a liquid crystal type display device 24 is controlled by a display control unit 25.

The electronic processor includes equipment for transmitting the records created. In the illustrated example, the transmission device is of an acoustic type, and includes a voltage controlled oscillator (VCO) 26 which receives an analog signal supplied from a transducer 25 and whose output signal drives an acoustic transducer 27 comprising a piezoelectric transducer or the like.

The electronic processor also includes a circuit 28 that calculates the pulse rate by, for example, detecting the QRS interval of the electrocardiogram and repeatedly calculating the pulse rate during recording of the electrocardiogram. The device also includes a real time clock 29 controlled by a crystal 31, for example.

The electronic processor is controlled by a number of knobs or pushbuttons. Of these, pushbutton 16 controls the recording of the electrocardiogram, knob 32 controls the display of the pulse rate, two pushbuttons 33 and 34 set the upper and lower pulse rate thresholds, and pushbutton 35 controls the electrocardiogram display. Controlling the length of the recording, knob 36 controls the display of time and enables pushbutton 37 to set the clock time.

The electronic processing unit is a modified circuit and occupies very little space. Accordingly, in one embodiment of the invention, the housing 3 has dimensions of 60 mm in length, 40 mm in width, and 18 mm in thickness, and weighs only 100 g.

In the first mode of operation described above, when knob 16 is moved, the device is energized, and when knob 16 is later moved further, recording of an electrocardiogram whose length has already been set by the physician using knob 35 begins. be done.

In a second mode of operation, the electrode 2 is replaced by a sub-electrode set 7, 13, 14, 15 and 16 via a sub-electrode 7 or a sub-device 9. The electronic circuit continuously records the electrocardiogram, and when the knob 16 is moved, the control unit 21 stores an electrocardiogram corresponding to a period of time before and after the knob 16 is moved, for example 20 seconds earlier and 20 seconds later. control. The length of the recording is again set by pushbutton 35.

Records stored in digital form in the memory 23 may be read out by the doctor in the clinic or transferred to the transducer 2.
2, the signal is converted into an analog format and then transmitted by telephone via circuit 26 and converter 27.

In a third mode of operation, the device is in a monitoring state. That is, the housing 3 is connected to the auxiliary electrode 7, and the display displays the pulse rate calculated by the circuit 28.
If the pulse rate exceeds one of the values set by pushbuttons 33 and 34, an audible or visual alarm is sounded.

In this mode of operation, a simple device having neither a memory nor a transmission device may be used. Such devices are particularly useful for sportsmen and the like.

FIG. 7 is a schematic block diagram of the circuitry in subdevice 9. This device is connected to a sub-electrode 7 located below the sub-device 9 and to other electrodes 13, 14 and 15, which are preferably ambaratri type electrodes. Among the electrodes, two electrodes 13 and 14 are placed on the upper part of the patient's chest, as shown in FIG.
is placed at the patient's heart site. The output of the multiplexer is from a first one-channel line 42 which is connected directly to the male coupling electrical connector member 11 and a second two-channel output 43 which is connected to a signal processing unit 44 which outputs to the male coupling member 11. Become. Multiplexer 41 and calculation unit 44 are controlled by control unit 45.

In response to commands from the control unit 45, the multiplexer 41 connects the second electrode 2, the auxiliary electrode 7 and the other electrode 1.
3, 14 and 15 is obtained, one of the other electrodes is connected to one of the inputs of the amplifier 17. Alternatively, the multiplexer 41 connects the sub-electrode and other electrodes to the calculation circuit 44 to generate a composite signal to the electronic controller of the housing 3A.
Connect to. In this way, the electrodes 2, 7, 13,
Different electrocardiogram graphs are obtained corresponding to two combinations of 14 and 15. The electrocardiogram obtained in this way corresponds to that obtained with the fixation device. Those records are recorded by a device called ``Sentinel.''
mode, different combinations of electrodes are sequentially connected by the control circuit 45 to the electronic processor of the housing 3A.

Effects of the Invention According to the present invention, electrocardiograms can be recorded very easily under various conditions, and the device can be handled very easily. The recordings obtained are of high quality and comparable to recordings obtained with fixed recording devices. The user does not experience any inconvenience when wearing the device, and can use it regardless of what kind of clothing he or she wears.

The above-described embodiments of the invention are merely examples and modifications and variations may easily be made within the scope of the invention. In particular, electrode support means other than a harness or shoulder girdle as described above may be provided. Further, the link 1 can have a spiral shape from approximately the clavicle to 2 to 3 centimeters inside the housing.

[Brief explanation of the drawing]

1 and 2 are rear and front views, respectively, of a patient wearing a device according to an embodiment of the present invention;
Fig. 3 is a rear view of the casing of the first electrode section shown in Fig. 2, and Fig. 4 is a cross-sectional view of the casing along the line - in Fig. 3 with the sub-electrode attached thereto. , Fig. 5 is a cross-sectional view of the sub-device and sub-electrode attached to the housing, and Fig. 6 is one of the electronic signal processing devices in the device.
FIG. 7 is a schematic block diagram of an example of the electronic circuit in the sub-device, and FIG. 8 is a diagram showing another example of the arrangement of electrodes. DESCRIPTION OF SYMBOLS 1... Strap, 2... Second electrode, 3... First electrode, 3A... Housing, 4... Surface, 5... Electrode, 6... Female part, 7... Sub-electrode, 8... Male part, 9... Sub-device , 11
...Male part, 12...Female part, 13, 14, 15...Other electrodes, 16...Push button, 17...Differential amplifier, 1
8... Analog to digital converter, 19... Bus, 21... Control processing logic unit, 22... Digital to analog converter, 23... Memory, 24...
Display device, 25...Display control unit, 26...Voltage controlled oscillator, 27...Acoustic transducer, 28...Calculation circuit, 29...Clock, 31...Crystal, 32, 36...Knob, 33, 34, 35, 37
...Push button, 41...Multiplexer, 42...1 channel line, 43...2 channel output, 44
...signal processing unit, 35...control unit.

Claims (1)

[Claims] 1. A flexible loop made of a conductor that is hung around the patient's neck, and a flexible loop that is attached to the loop and suspended from the patient's chest like a pendant, and that moves the position of contact with the patient's skin. is possible and includes a housing, a first electrode part 3 including a first electrode provided on the housing, a second electrode 2 attached to the part of the loop that is hung around the patient's neck, and an electronic processing means for recording electrocardiogram signals detected by the first electrode part and the second electrode part provided in the housing, and the second electrode is A portable cardiac activity monitoring device that is in constant contact with the skin of the patient's neck. 2. The first electrode section 3 comprises a housing 3A attached to the loop and a first electrode 5 provided on the housing. Cardiac activity monitoring portable device. 3 The first electrode part 3 is electrically connected to the housing 3A attached to the loop, the first electrode 5 provided in the housing, and the first electrode to the housing 3A. A portable device for monitoring cardiac activity according to claim 1, characterized in that the device comprises a sub-electrode (7) attached to the patient's skin, the sub-electrode being fixed to the patient's skin. 4 The first electrode section 3 is electrically connected to the housing 3A attached to the loop, the first electrode 5 provided on the housing, and the first electrode and connected to the housing 3A. It consists of a sub-housing 9 attached to the sub-housing 9, and a sub-electrode 7 attached to the sub-housing and fixed to the patient's skin, and the sub-housing has another electrode 13 fixed to a different part of the patient's chest. . 5. The portable device for monitoring cardiac activity according to claim 2, wherein the first electrode and the second electrode are flexible and made of twisted conductors. 6. The electronic processing means includes analog-to-digital converter means responsive to signals from the electrodes, digital storage means for storing signals from the analog-to-digital converter means, and storage means for storing the signals in the storage means. 2. A portable device for monitoring cardiac activity according to claim 1, further comprising a triggering push button. 7. The storage means comprises a stacked memory format which is continuously responsive to the signals, and the triggering means causes permanent storage of the signals in the stacked memory format so that an electrocardiogram corresponding to a period of time prior to manual actuation of the triggering means is recorded. 7. The portable device for monitoring cardiac activity according to claim 6, characterized in that the device is configured to: 8. Claim 1, wherein the electronic processing means includes means for responding to the patient's pulse rate relative to a preset threshold and issuing an alarm when the pulse rate exceeds the threshold. A portable cardiac activity monitoring device as described. 9. The portable device for monitoring cardiac activity according to claim 3, wherein the sub-electrode is attached with an adhesive. 10. The portable cardiac activity monitoring device of claim 1, wherein said electronic processing means includes transmission means for generating an acoustic signal in response to said electrocardiogram signal for transmission to a remote receiver. 11. A portable cardiac activity monitoring device according to claim 4, wherein said sub-housing includes multiplexer means for transmitting signals from said other electrodes to said electronic processing means.